For how PrEP works, dosing protocols (daily, on-demand 2-1-1, injectable), and what to expect medically, read PrEP Mechanics: Daily, On-Demand & Injectable first. This guide covers the European-specific picture: who pays, how to access it, and what's currently available where.
Cost by Country
| Coverage | Countries |
|---|---|
| Free / heavily subsidised | France, UK, Ireland, Sweden, Denmark, Italy, Spain, Portugal, Netherlands, Belgium, Germany (via insurance) |
| Partial / variable | Poland, Czech Republic, Austria, Greece |
| High cost / limited access | Romania (~€50–80/month generics privately), Hungary, Bulgaria, Croatia |
Most countries require confirmed HIV-negative status and, in some cases, a documented risk profile. Your local sexual health clinic can confirm eligibility criteria.
Generics: The Route Around High Cost
Brand-name Truvada costs €1,500–2,000/month where not publicly funded. Generic TDF/FTC (e.g., Tenvir-EM) is chemically identical and 5–10× cheaper. If you're paying privately, ask specifically for generics.
On-demand 2-1-1 dosing is only validated for TDF/FTC (Truvada and generics). Descovy (TAF/FTC) must be taken daily. See PrEP Mechanics for full protocol detail.
How to Access PrEP in Europe
Sexual health clinic (recommended): The standard route in every EU country. Often free or covered. Waiting lists of weeks to months in busier cities are common — call ahead.
Online / telemedicine: Services operating from countries with subsidised PrEP (France, UK) sometimes serve EU patients via video consultation + local bloodwork. Faster than waiting lists but regulatory status varies by home country. You take on responsibility for monitoring.
Cross-border prescription: Technically permitted under EU law but pharmacies in your home country may refuse to fill a foreign prescription. Works inconsistently in practice.
Private purchase: Last resort. €400–800/month for generics depending on source. No built-in medical supervision; you manage your own monitoring.
Injectable PrEP (Cabotegravir / Vocabria) in Europe
Cabotegravir received EMA approval and is rolling out across Europe. Two loading injections one month apart, then once every two months. Current status:
- Available: France, UK, Sweden, Netherlands, Spain
- Rolling out: Germany, Belgium, Italy
- Limited / unavailable: Most of Eastern and Central Europe
Ask your sexual health clinic whether it's available in your area. See PrEP Mechanics for the startup protocol and the important note on stopping injectable PrEP safely.
Related:
- > PrEP Mechanics: Daily, On-Demand & Injectable — protocols, side effects, what to expect
- > STI Testing in Europe: Access & Costs — the 3-monthly monitoring cycle that runs alongside PrEP
- > U=U: Undetectable Equals Untransmittable — how PrEP and U=U interact in serodiscordant couples
- > PEP in Europe: Emergency Access — if PrEP wasn't in place
- > Finding an LGBTQ+-Affirming Doctor — finding a provider who'll prescribe PrEP without resistance